“Will Medicine rediscover the Soul?”

Doctors living longer is a growing breed. Longer living doctors serving generations of patients longer and longer are on the rise, too. However, those of them with a pedigree and a genius to effortlessly navigate way outside the box – remain a rarity. I have had the privilege of knowing one such.

The reason for writing this blog coincides with the publication of ‘To Talk Of Many Things‘. It is much more than a biographical account of nonagenarian Dr. Lalit Kothari’s glorious journey before, during and beyond the medical profession. While he had a brief stint as a student of liberal arts – growing up in a family of distinguished scientists, science was bound to draw him in. He chose medicine. Human Physiology has ever since been a lifetime passion as he endeavours to refine the art of medicine as a science of happiness.

The latest book echoes of an earlier title by him: ‘Man, Medicine And Morality‘ – a bouquet of withered flowers, with a subtle fragrance – as he calls it. Given his penchant for literature and history, he dips the readers into four key themes, in a unique style. Evolutionary history of medicine; ethical and cultural aspects of health, and healthcare; health beyond medicine; medical education, and the exciting life of medical students and doctors. All with a trademark sense of humour. For anyone wishing to explore Dr. Kothari’s written works – must draw the nuggets from these two books in conjunction.

Medicine: The Art

Modern medicine is science, but its use on individual patients – men and women, young and old, rich and poor, the confident and the skeptics – is almost an art.

The good physician humanizes the science of medicine. He adds human understanding, sympathy and hope to his science, drawing from the rich traditions of his noble art.

Following Descartes, we may consider man as a sophisticated machine but, unfortunately, the Celestial Manufacturer provides no handbook or operating manual to tell us how it should be handled and serviced!

Following Descartes, we may consider man as a sophisticated machine but, unfortunately, the Celestial Manufacturer provides no handbook or operating manual to tell us how it should be handled and serviced! That makes the work of a physician very difficult and challenging, and mistakes occur. With each patient different from all others (except in the case of identical twins, or clones of the future) because of the unique and infinite randomization of our genes, the doctor has the scope of an artist to do his work.

When medical science can no longer help the patient, the wise doctor carefully uses all his experience and skill to keep alive the patient’s hope and will to live. This is the Art of medicine.

Fault lines

Can health care be purely an industry? Doctors are entrapped on all sides by relentless pressure from pharmaceutical industry. Like a mysterious force-field emanating from a network of medical representatives, it is modulating every aspect of the medical profession, from treating patients to conferencing in Honolulu.

Take for instance an area where medicine and morality are sometimes at conflict, he points out, relates to the use of drugs. In India, more than 70,000 drugs or drug formulations are being sold in the market. Despite the World Health Organisation (WHO) having declared that this number is ridiculous and only 250 or so are normally needed.

In India, more than 70,000 drugs or drug formulations are being sold in the market. Despite the World Health Organisation (WHO) having declared that this number is ridiculous and only 250 or so are normally needed.

Medical education, he laments, provides only a surfeit of ‘mental experience’, some little ‘manual experience’ but no ‘moral experience’ at all. Just when the concern for morality in medicine is gaining momentum. The teaching of medicine is unique in the sense that half of it is on a blackboard and half around living patients in the hospital. This requires great sensitivity and experience. Traditional old hospitals will have to be reborn to function as a medical college hospital. It must be fully prepared to perform its 3 vital functions: Patient-Care, Teaching, Research. Only then will the hospital perform its full purpose.

From the beginning, I was constantly searching for ways to make physiology more and more interesting and clinically useful for students, he says. Teachers should also respect and admire their students; normally we expect only the students to respect their teachers.

Individual masters of healing art as the very embodiment of the highest human values? Dr. Kothari’s top picks being Charak, Sushruta, Hippocrates and Galen. And he reminds us of Sir William Osler’s famous words: “One of the duties of a doctor is to educate the community not to take medicines”.

Moral commitment of a health care establishment cannot be better stated, he illustrates, than this engravement on the gate of renowned medical missionary late Dr. Albert Schweitzer’s jungle hospital in Lambarene, Gabon (Africa): “Here, at whatever hour you come, you will find LIGHT and HELP and human KINDNESS”.

Talking of many things

That doctors rarely see any books beyond their text-books never got into the way of his vast explorations. The Time has now come to talk of many things. But is anyone listening? He draws from ‘Of cabbages and kings’ – Alice in Wonderland.

If only had Queen Mumtaz Mahal not died during her fourteenth delivery, in 1631, Emperor Shahjahan might not have thought of the Taj Mahal. Likewise, have you ever wondered what an important role diseases have played in shaping the course of history? From Alexander the Great, Napoleon, Franklin D. Roosevelt, George Washington!

Then he takes you through – Mahabharat; relaxing in the modern world; yoga; power of thinking; spirituality; superstition; Charles Sherrington to Alexis Carrel to Aldous Huxley; Charles Dickens; Wordsworth; medical progress in the 20^th century; health and culture; nonviolence. TS Eliot, The Time Machine, Descartes, Tantra, Rasputin, doctor patient relationship; The Monkey Who Peeped through the Key-hole; George Bernard Shaw & His Tailor; Paulo Coelho.

We have discovered the science of life, but not the Science of living. Will medicine rediscover the soul?

Healthcare beyond medicine has been his constant pursuit. We have discovered the science of life, but not the Science of living. Will medicine rediscover the soul? Strangely the word ‘soul’ which has completely disappeared from all modern textbooks of medicine, he laments. Incidentally, it occurs frequently in Alexis Carrel’s book.

In search of happiness

Where have I gathered all these anecdotes and historical stories? I really don’t know, he quips! For the polymath in him, perhaps this is his way to stay happy. While Dr. Kothari wraps up the book ahead of the onset of the pandemic, his deep concerns touch upon the many fault lines we have seen manifest as vaccine apartheid and profits before people. He yearns for the soul to return to medicine, however, it is eventually the quest for happiness that he believes is the most fundamental pursuit.

Happiness can be both elusive and evasive! He quotes Somerset Maugham from ‘The Summing Up‘. “I saw in the wards what hope looked like; and fear and relief. I saw the dark lines that despair drew on a face. I saw courage and steadfastness. I saw the gallantry that made a man greet death with an ironic smile because he was too proud to let those near him see the terror in his soul.” All the more reason as to why it is worth seeking.

In his impressive list of influencers two that stand out the most are – his late father Padma Vibhushan Dr. Daulat Singh Kothari, an eminent scientist, and Mahatma Gandhi – both a rare embodiment of austerity and self-effacement. With a moral compass such as this, our good doctor’s Rx should not be any surprise: “Seeking Happiness? Count Your Blessings and Be Happy”.

“My formula is easy and it has a use for every human”, he tells me.